Provider Demographics
NPI:1194004614
Name:AMERICAN MEDICAL DISTRIBUTION
Entity Type:Organization
Organization Name:AMERICAN MEDICAL DISTRIBUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:GAROFANI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:866-327-9194
Mailing Address - Street 1:7300 124TH AVE
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773
Mailing Address - Country:US
Mailing Address - Phone:866-327-9194
Mailing Address - Fax:888-920-9370
Practice Address - Street 1:7300 124TH AVE
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773
Practice Address - Country:US
Practice Address - Phone:800-327-9194
Practice Address - Fax:727-507-7645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6706890001Medicare NSC